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To determine the relative efficacy and safety of the treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>RCTs were identified from a Rapid Literature Review and a published systematic review. Identified RCTs were subject to data-extraction and narrative review. Eligible RCTs were included in evidence networks to determine relative efficacy and safety of the treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 44 RCTs (pertaining to eleven treatments), were identified for data-extraction and narrative review; 37 in the second-line setting, five in the second- and later-line setting and two in the third- and later-line setting. Evidence networks were feasible for the second-line treatments only. No statistically significant differences, across treatments, for key efficacy outcomes (overall-survival, progression-free survival), and additional outcome (objective-response rate) were identified. Pembrolizumab was associated with a statistically significant decreased risk of Grade \u2265 3 treatment-related adverse effects versus paclitaxel; no other significant differences, across treatments, were identified for this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The appreciable number of RCTs identified indicates that the treatment landscape here is rapidly evolving. The introduction of novel treatments, in the second-line setting, has not had a statistically significant impact on key efficacy outcomes, and has had little impact on safety outcomes, versus more established treatments. There remains a need for novel treatments that will have a significant benefit on efficacy and safety outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12029-026-01407-z","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T08:34:39Z","timestamp":1770366879000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relative Clinical Efficacy and Safety of Second- or Later-Line Treatments for Advanced and Metastatic Gastric Cancer: A Rapid Review and Network Meta-Analysis"],"prefix":"10.1007","volume":"57","author":[{"given":"Shikha","family":"Sharma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"McConnell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niamh","family":"Carey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacintha","family":"O\u2019Sullivan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Kearns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maeve","family":"Lowery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"McCullagh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"For the HEALED Consortium","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"McConnell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Carey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"O\u2019Sullivan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Kearns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Lowery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"McCullagh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"issue":"3","key":"1407_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, et al. 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